arXiv subjects

Oriel Perets

Publications and source records attributed to Oriel Perets.

5 recordsLinked to original sources

arXiv2026

MedUPS: Towards Diagnostic Assistance in Uncommon Medical Cases with Large Language Models

Uncommon and off-guideline cases are difficult for clinical decision support, because physicians must make a series of management decisions under diagnostic uncertainty and rarely see the full case at once. Most large language model (LLM) benchmarks for medicine score only the final diagnosis, yet much of clinical care turns on the next appropriate action: the next test to order, the imaging study to obtain, the specialist to involve, or the differential to pursue. We introduce MedUPSQA, a dataset of 21,874 mid-stream clinical decision points built from 5,535 real case reports, and MedUPS, an alignment framework that supervises models on these intermediate decisions as they unfold along a patient's trajectory. We segment free-text case presentations into chronologically ordered, accumulating clinical chunks and align models to predict the next step with reinforcement learning (GRPO), using an external LLM-as-a-Judge reward. This objective mirrors how clinicians actually meet patients, reasoning forward from accumulating evidence toward the next decision, rather than committing to a final label. Across three backbones, mid-stream alignment raises next-step accuracy from 55.2 to 66.7 for Qwen3.6-27B, from 47.2 to 57.8 for Qwen3.5-9B, and from 37.8 to 44.4 for HuatuoGPT-3-8B, with 95% CI. In several model scales we test the objective improves accuracy more than scale, with smaller models surpassing larger, frontier models we evaluate. We further train supervised fine-tuning (SFT) baselines on the mid-stream task, SFT improves all backbones above base, indicating the target framwork carries signal independently of the optimizer. We release the dataset, code, and aligned checkpoints.

cs.CL↗

arXiv2026

ProtSent: Protein Sentence Transformers

Protein language models (pLMs) produce per-residue representations that capture evolutionary and structural information, yet their mean-pooled sequence embeddings are not explicitly trained to reflect functional, evolutionary or structural similarity between proteins. We present Protein Sentence Transformers (ProtSent), a contrastive fine-tuning framework for adapting PLMs into general-purpose embedding models. ProtSent trains with MultipleNegativesRankingLoss across five protein-pair datasets: Pfam families, structurally derived hard negatives, AlphaFold DB structural pairs, and StringDB protein--protein interactions, and Deep Mutational Scanning data. We evaluate on 23~downstream tasks using frozen embeddings with a k-nearest-neighbor probe to measure embedding neighborhood quality. On ESM-2 150M, ProtSent improves 15 of 23 tasks, with gains of +105% on remote homology detection, +17% on variant effect prediction, and +19.9% Recall@1 on SCOPe-40 structural retrieval. The 35M variant improves 16 of 23 tasks with +40.5% on remote homology and +15.5% Recall@1 on SCOPe-40. Contrastive fine-tuning restructures the embedding space to better capture protein function and structure, without any task-specific supervision. We release the models, public data, and training recipe and code.

cs.LG↗

arXiv2025

CUPCase: Clinically Uncommon Patient Cases and Diagnoses Dataset

Medical benchmark datasets significantly contribute to developing Large Language Models (LLMs) for medical knowledge extraction, diagnosis, summarization, and other uses. Yet, current benchmarks are mainly derived from exam questions given to medical students or cases described in the medical literature, lacking the complexity of real-world patient cases that deviate from classic textbook abstractions. These include rare diseases, uncommon presentations of common diseases, and unexpected treatment responses. Here, we construct Clinically Uncommon Patient Cases and Diagnosis Dataset (CUPCase) based on 3,562 real-world case reports from BMC, including diagnoses in open-ended textual format and as multiple-choice options with distractors. Using this dataset, we evaluate the ability of state-of-the-art LLMs, including both general-purpose and Clinical LLMs, to identify and correctly diagnose a patient case, and test models' performance when only partial information about cases is available. Our findings show that general-purpose GPT-4o attains the best performance in both the multiple-choice task (average accuracy of 87.9%) and the open-ended task (BERTScore F1 of 0.764), outperforming several LLMs with a focus on the medical domain such as Meditron-70B and MedLM-Large. Moreover, GPT-4o was able to maintain 87% and 88% of its performance with only the first 20% of tokens of the case presentation in multiple-choice and free text, respectively, highlighting the potential of LLMs to aid in early diagnosis in real-world cases. CUPCase expands our ability to evaluate LLMs for clinical decision support in an open and reproducible manner.

cs.CL↗

arXiv2024

DSF-GAN: DownStream Feedback Generative Adversarial Network

Utility and privacy are two crucial measurements of the quality of synthetic tabular data. While significant advancements have been made in privacy measures, generating synthetic samples with high utility remains challenging. To enhance the utility of synthetic samples, we propose a novel architecture called the DownStream Feedback Generative Adversarial Network (DSF-GAN). This approach incorporates feedback from a downstream prediction model during training to augment the generator's loss function with valuable information. Thus, DSF-GAN utilizes a downstream prediction task to enhance the utility of synthetic samples. To evaluate our method, we tested it using two popular datasets. Our experiments demonstrate improved model performance when training on synthetic samples generated by DSF-GAN, compared to those generated by the same GAN architecture without feedback. The evaluation was conducted on the same validation set comprising real samples. All code and datasets used in this research will be made openly available for ease of reproduction.

cs.LG↗

arXiv2023

Subpopulation-Specific Synthetic EHR for Better Mortality Prediction

Electronic health records (EHR) often contain different rates of representation of certain subpopulations (SP). Factors like patient demographics, clinical condition prevalence, and medical center type contribute to this underrepresentation. Consequently, when training machine learning models on such datasets, the models struggle to generalize well and perform poorly on underrepresented SPs. To address this issue, we propose a novel ensemble framework that utilizes generative models. Specifically, we train a GAN-based synthetic data generator for each SP and incorporate synthetic samples into each SP training set. Ultimately, we train SP-specific prediction models. To properly evaluate this method, we design an evaluation pipeline with 2 real-world use case datasets, queried from the MIMIC database. Our approach shows increased model performance over underrepresented SPs. Our code and models are given as supplementary and will be made available on a public repository.

cs.LG↗